Periodontal disease associated with increased oral cancer odds in meta-analysis of case-control studies
This systematic review and meta-analysis examined the association between periodontal disease and oral cancer across 18 case-control studies from 13 regions, involving 31,504 human subjects aged over 18. The analysis compared individuals with periodontal disease to those without, with the primary outcome being odds of developing oral and/or head and neck cancers.
The main analysis found periodontal disease was associated with significantly increased odds of oral cancer (odds ratio 3.35, 95% CI 2.63-4.26; P < .001). After adjustment for potential confounders, the association remained significant though attenuated (adjusted odds ratio 2.32, 95% CI 1.71-3.15; P < .001). Effect sizes varied depending on the periodontal disease case definition used, ranging from OR 2.02 when defined by missing teeth to OR 2.68 when using American Academy of Periodontology clinical parameters.
Safety and tolerability data were not reported in the included studies. Key limitations include the observational case-control design, which cannot establish causation, and potential residual confounding despite adjustment. The authors suggest these findings warrant interdisciplinary attention, but clinicians should interpret the association cautiously given the inherent limitations of case-control evidence.